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ABVMA Application, Licence and Payment Receipt
Saskatchewan Society of Medical Laboratory Technologists
PO Box 3837 Regina, SK S4P3R8
Phone : (306)352-6791 | Toll-free : (877)334-3301 | http://www.ssmlt.org
{%CLIENT: First Name%} {%CLIENT: Last Name%}
{%CLIENT: Home Address: STREET 1%} {%CLIENT: Home Address: STREET 2%}
{%CLIENT: Home Address: CITY%}, {%CLIENT: Home Address: PROVINCE_CODE%} 
{%CLIENT: Home Address: POSTAL%}
SSMLT # {%CLIENT: SSMLT ID%} CSMLS # {%CLIENT: CSMLS ID%}
SSMLT Cat. {%CLIENT: Membership Category: LABEL%} CSMLS Cat. {%CLIENT: CSMLS Status: LABEL%}

Note :  
Amounts are in accordance with the Medical Laboratory Technologists Act(1995) Saskatchewan. The SSMLT is authorized to collect dues and issue Tax receipts on behalf of the CSMLS. Application fees, penalties, and employer paid fees are NOT income tax deductible.

Saskatchewan Society of
Medical Laboratory Technologists
{%Members: _MEMBERSHIP_END_DATE_[yyyy]%}
Member Name : {%CLIENT: First Name%} {%CLIENT: Last Name%}
Licence Status : {%CLIENT: Membership Category: LABEL%}
{%CLIENT: Scope of Practice%}  {%CLIENT: Scope of Practice 2%} 
{%CLIENT: Scope of Practice 3%}  {%CLIENT: Scope of Practice 4%} 
Registration Number : {%CLIENT: SSMLT ID%}
Effective Date : {%Members: _MEMBERSHIP_START_DATE_[MMMM dd, yyyy]%} Expiry Date : {%CLIENT: Expiry Date[MMMM dd, yyyy]%}
Licence to Practice, issued under the
Medical Laboratory Technologists Act(1995)
 

Address Changes:
Log on to www.ssmlt.org to change address in profile.

Name Change:
Name change require a "Request for Name Change Form"
to be filled out Log on to www.ssmlt.org
Select "Name change request form" from the settings Menu